Chemotherapy Session in Turkey | Quality care at affordable costs 2024

Chemotherapy: What does it involve?

Chemotherapy uses one or more agents in different combinations, depending on the type of cancer. The combination of different substances makes it possible to attack cancer cells by simultaneously attacking different mechanisms that are essential for their replication.

There are national and international guidelines that define the different chemotherapy regimens (or protocols) to be used for different types of cancer. For each patient, physicians choose the most appropriate regimen to achieve the best possible outcome with the fewest side effects.

Chemotherapy regimens are referred to by acronyms made up of the initials of the drugs used. Examples include:

• CMF (cyclophosphamide, methotrexate, and fluorouracil)
• FEC (fluorouracil, epirubicin, and cyclophosphamide),often used to treat breast cancer
• FOLFOX (folacin, fluorouracil, and oxaliplatin)
• CAPOX (capecitabine and oxaliplatin),used to treat colorectal cancer. 

There are nearly a hundred substances that can be combined in various ways. The goal is to fight different types of cancer more effectively. New molecules are constantly being discovered, synthesized or extracted and developed in laboratories around the world, including Turkey.

Processing cycle

Chemotherapy is usually given over a period of three to six months. It usually consists of three to four to six to eight treatment cycles of varying lengths and intervals. The schedule may also change depending on the type of disease, the individual patient, and the individual's response to treatment.

For example, blood tests that show low levels of white blood cells (leukopenia) or platelets, or that suggest that the liver or kidneys are being affected by treatment, may lead the physician to increase the interval between treatments or decrease the dose of medication.

Other times, tests performed during treatment may show a poor response from the tumor mass, which is not shrinking despite treatment. This may lead doctors to use a different combination of drugs that may be more effective.

Finally, it is sometimes possible to consider the patient's needs when planning treatment cycles. Discussing these with the doctor well in advance makes it possible to schedule cycles so that they do not interfere with participation in important events.

When is it indicated?

Doctors consider several factors when deciding whether a patient should receive chemotherapy, including

• The type of tumor, which is more or less sensitive to these treatments.
• The location where the cancer first appeared.
• How the cancer cells look under a microscope, or how aggressive the cancer is.
• How far the disease has spread in the body from where it first appeared, i.e. the stage of the cancer.
• The general condition of the patient.

Chemotherapy options

Chemotherapy is suggested in the following cases:

Before surgery

This is called neoadjuvant chemotherapy. The goal of this treatment is to shrink the tumor to make surgery easier. It also aims to reduce the risk of the cancer coming back.

Adjuvant chemotherapy after surgery

Adjuvant chemotherapy is given after complete surgery to remove the tumor. That's when the surgeon has removed all visible cancer cells. The goal of chemotherapy is to reduce the risk of local or distant recurrence. The decision is based on the biological and histological characteristics of the tumor and the individual risk-benefit ratio. 

Chemotherapy after surgery is usually given intravenously.

Treatment of metastatic disease

Chemotherapy for metastatic disease is used to destroy cancer cells that have spread to other parts of the body.

Chemotherapy and Drugs Used

This therapy is used alone, in combination with radiation therapy, or as a preoperative treatment. Curative chemotherapy is indicated for most malignancies. Chemotherapy may vary depending on the type of cancer.

When is it not indicated?

A diagnosis of cancer does not necessarily mean chemotherapy, which, as a systemic treatment (i.e., one that spreads throughout the body),has side effects that must be weighed against the expected benefits.

Doctors may therefore decide not to subject the patient to this type of treatment:

• If the tumor is unlikely to respond well or at all to this type of treatment because of its characteristics
• If the tumor is still small, has not spread to the lymph nodes or bloodstream, and can be completely removed by surgery.
• In other cases, evaluated by specialists

Side effects of Chemotherapy

The side effects of chemotherapy vary depending on the chemicals used, the individual, and the dosage.

• Hair loss, also known as alopecia. This is a very noticeable effect that temporarily affects hair, eyelashes, and eyebrows. Hair loss usually begins 2 to 3 weeks after the start of treatment, and hair regrowth begins 6 to 8 weeks after the last infusion.
• Red blood cells, white blood cells, and platelets decrease. In fact, a significant drop in red blood cells (anemia) occurs 2 to 3 weeks after the first infusion, causing persistent fatigue. A notable drop in white blood cells (leukopenia),leading to an increased risk of infection, and a drop in platelets (thrombocytopenia),which can lead to bruising and bleeding.
• Mouth lesions: mucous membranes become more sensitive and fragile during chemotherapy.
• Skin lesions: chemotherapy can cause redness, dryness, and tightness.

Chemotherapy can be used alone or in combination with other treatments such as surgery or radiation, but side effects are inevitable.

How to alleviate the Side Effects of Chemotherapy?

Chemotherapy can be used alone or with other treatments, such as surgery or radiotherapy, but its side effects are unavoidable.

Here are some tips that may help you feel better during your chemotherapy:

• Start by changing your eating habits to avoid nausea and vomiting.
• Consume apple and lemon juice, flat ginger ale, and tea after your repasts.
• After your doctor's approbation, take anti-nausea drugs.
• Try acupuncture and relaxation techniques like deep breathing and meditation.
• Cut your hair and use sunscreens to protect your weakened skin.